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A Nordic survey of CT doses in hybrid PET/CT and SPECT/CT examinations

Bebbington, Natalie A. ; Haddock, Bryan T. ; Bertilsson, Henrik ; Hippeläinen, Eero ; Husby, Ellen M. ; Tunninen, Virpi I. and Söderberg, Marcus LU orcid (2019) In EJNMMI Physics 6(1).
Abstract

Background: Computed tomography (CT) scans are routinely performed in positron emission tomography (PET) and single photon emission computed tomography (SPECT) examinations globally, yet few surveys have been conducted to gather national diagnostic reference level (NDRL) data for CT radiation doses in positron emission tomography/computed tomography (PET/CT) and single photon emission computed tomography/computed tomography (SPECT/CT). In this first Nordic-wide study of CT doses in hybrid imaging, Nordic NDRL CT doses are suggested for PET/CT and SPECT/CT examinations specific to the clinical purpose of CT, and the scope for optimisation is evaluated. Data on hybrid imaging CT exposures and clinical purpose of CT were gathered for 5... (More)

Background: Computed tomography (CT) scans are routinely performed in positron emission tomography (PET) and single photon emission computed tomography (SPECT) examinations globally, yet few surveys have been conducted to gather national diagnostic reference level (NDRL) data for CT radiation doses in positron emission tomography/computed tomography (PET/CT) and single photon emission computed tomography/computed tomography (SPECT/CT). In this first Nordic-wide study of CT doses in hybrid imaging, Nordic NDRL CT doses are suggested for PET/CT and SPECT/CT examinations specific to the clinical purpose of CT, and the scope for optimisation is evaluated. Data on hybrid imaging CT exposures and clinical purpose of CT were gathered for 5 PET/CT and 8 SPECT/CT examinations via designed booklet. For each included dataset for a given facility and scanner type, the computed tomography dose index by volume (CTDIvol) and dose length product (DLP) was interpolated for a 75-kg person (referred to as CTDIvol,75kg and DLP75kg). Suggested NDRL (75th percentile) and achievable doses (50th percentile) were determined for CTDIvol,75kg and DLP75kg according to clinical purpose of CT. Differences in maximum and minimum doses (derived for a 75-kg patient) between facilities were also calculated for each examination and clinical purpose. Results: Data were processed from 83 scanners from 43 facilities. Data were sufficient to suggest Nordic NDRL CT doses for the following: PET/CT oncology (localisation/characterisation, 15 systems); infection/inflammation (localisation/characterisation, 13 systems); brain (attenuation correction (AC) only, 11 systems); cardiac PET/CT and SPECT/CT (AC only, 30 systems); SPECT/CT lung (localisation/characterisation, 12 systems); bone (localisation/characterisation, 30 systems); and parathyroid (localisation/characterisation, 13 systems). Great variations in dose were seen for all aforementioned examinations. Greatest differences in DLP75kg for each examination, specific to clinical purpose, were as follows: SPECT/CT lung AC only (27.4); PET/CT and SPECT/CT cardiac AC only (19.6); infection/inflammation AC only (18.1); PET/CT brain localisation/characterisation (16.8); SPECT/CT bone localisation/characterisation (10.0); PET/CT oncology AC only (9.0); and SPECT/CT parathyroid localisation/characterisation (7.8). Conclusions: Suggested Nordic NDRL CT doses are presented according to clinical purpose of CT for PET/CT oncology, infection/inflammation, brain, PET/CT and SPECT/CT cardiac, and SPECT/CT lung, bone, and parathyroid. The large variation in doses suggests great scope for optimisation in all 8 examinations.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Computed tomography, Diagnostic reference levels, Dosimetry, Hybrid imaging, PET/CT, SPECT/CT
in
EJNMMI Physics
volume
6
issue
1
article number
24
publisher
Springer
external identifiers
  • scopus:85076491260
  • pmid:31845047
ISSN
2197-7364
DOI
10.1186/s40658-019-0266-7
language
English
LU publication?
yes
id
b46b077f-a722-46a8-9a9c-85a846a81523
date added to LUP
2020-01-07 14:48:30
date last changed
2024-04-03 00:06:02
@article{b46b077f-a722-46a8-9a9c-85a846a81523,
  abstract     = {{<p>Background: Computed tomography (CT) scans are routinely performed in positron emission tomography (PET) and single photon emission computed tomography (SPECT) examinations globally, yet few surveys have been conducted to gather national diagnostic reference level (NDRL) data for CT radiation doses in positron emission tomography/computed tomography (PET/CT) and single photon emission computed tomography/computed tomography (SPECT/CT). In this first Nordic-wide study of CT doses in hybrid imaging, Nordic NDRL CT doses are suggested for PET/CT and SPECT/CT examinations specific to the clinical purpose of CT, and the scope for optimisation is evaluated. Data on hybrid imaging CT exposures and clinical purpose of CT were gathered for 5 PET/CT and 8 SPECT/CT examinations via designed booklet. For each included dataset for a given facility and scanner type, the computed tomography dose index by volume (CTDI<sub>vol</sub>) and dose length product (DLP) was interpolated for a 75-kg person (referred to as CTDI<sub>vol,75kg</sub> and DLP<sub>75kg</sub>). Suggested NDRL (75th percentile) and achievable doses (50th percentile) were determined for CTDI<sub>vol,75kg</sub> and DLP<sub>75kg</sub> according to clinical purpose of CT. Differences in maximum and minimum doses (derived for a 75-kg patient) between facilities were also calculated for each examination and clinical purpose. Results: Data were processed from 83 scanners from 43 facilities. Data were sufficient to suggest Nordic NDRL CT doses for the following: PET/CT oncology (localisation/characterisation, 15 systems); infection/inflammation (localisation/characterisation, 13 systems); brain (attenuation correction (AC) only, 11 systems); cardiac PET/CT and SPECT/CT (AC only, 30 systems); SPECT/CT lung (localisation/characterisation, 12 systems); bone (localisation/characterisation, 30 systems); and parathyroid (localisation/characterisation, 13 systems). Great variations in dose were seen for all aforementioned examinations. Greatest differences in DLP<sub>75kg</sub> for each examination, specific to clinical purpose, were as follows: SPECT/CT lung AC only (27.4); PET/CT and SPECT/CT cardiac AC only (19.6); infection/inflammation AC only (18.1); PET/CT brain localisation/characterisation (16.8); SPECT/CT bone localisation/characterisation (10.0); PET/CT oncology AC only (9.0); and SPECT/CT parathyroid localisation/characterisation (7.8). Conclusions: Suggested Nordic NDRL CT doses are presented according to clinical purpose of CT for PET/CT oncology, infection/inflammation, brain, PET/CT and SPECT/CT cardiac, and SPECT/CT lung, bone, and parathyroid. The large variation in doses suggests great scope for optimisation in all 8 examinations.</p>}},
  author       = {{Bebbington, Natalie A. and Haddock, Bryan T. and Bertilsson, Henrik and Hippeläinen, Eero and Husby, Ellen M. and Tunninen, Virpi I. and Söderberg, Marcus}},
  issn         = {{2197-7364}},
  keywords     = {{Computed tomography; Diagnostic reference levels; Dosimetry; Hybrid imaging; PET/CT; SPECT/CT}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{EJNMMI Physics}},
  title        = {{A Nordic survey of CT doses in hybrid PET/CT and SPECT/CT examinations}},
  url          = {{http://dx.doi.org/10.1186/s40658-019-0266-7}},
  doi          = {{10.1186/s40658-019-0266-7}},
  volume       = {{6}},
  year         = {{2019}},
}